Severe Hypothyroidism in Older People: Specific Features of Diagnosis and Treatment. Case Report and Literature Review
Year: 2015
Type: article
Study design: Case Report
Abstract: Prevalent causes of overt hypothyroidism are autoimmune destruction of the thyroid gland and previous thyroid surgery or radiation therapy. However, due to the side effects of amiodarone or lithium treatment thyroid dysfunction is increasingly frequent, especially in elderly patients who are anyway prone to a certain degree of hypothyroidism. This paper presents the case of a 66 years old patient who was admitted for severe physical asthenia and weight loss occurring during the past year. On admission we found anemia, which was considered secondary to a possible digestive tumor. The Comprehensive Geriatric Assessment (CGA) showed malnutrition, depression and a minor cognitive deficit. The absence of any obvious digestive cancer determined us to expand the investigation area. Cardiac ultrasound showed fluid in the pericardium which made us reconsider the diagnosis and take into account the presence of hypothyroidism, diagnosis that was subsequently confirmed by hormonal investigations and thyroid ultrasound. Hypothyroidism (either subclinical or overt forms) is a diagnosis that is easily overlooked in elderly patients because of its non-specific manifestations - symptoms may be wrongly attributed to normal aging or consequences of such diseases as depression, Parkinson or Alzheimer disease. Therefore, the measurement of serum thyroid-stimulating hormone (TSH) levels should be part of the biochemical work-up in all elderly subjects.
Source: The Medical-Surgical Journal
Institution: Grigore T. Popa University of Medicine and Pharmacy
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2549100534